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Title of Journal: Infection

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Abbravation: Infection

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Springer-Verlag

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10.1007/s15010-012-0359-x

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1439-0973

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Why is antimicrobial deescalation underprescribe

Authors: E Duchêne E Montassier D Boutoille J Caillon G Potel E Batard
Publish Date: 2012/11/04
Volume: 41, Issue: 1, Pages: 211-214
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Abstract

A retrospective study of inpatients age 15 years at a large academic hospital who were empirically treated for urinary tract infections due to Escherichia coli susceptible to at least one of the following antibacterial agents amoxicillin coamoxiclav and cotrimoxazole Deescalation was defined as the replacement of the empirical broadspectrum therapy by amoxicillin coamoxiclav or cotrimoxazoleEighty patients were included Deescalation was prescribed for 32 of 69 patients for whom it was possible from both a bacteriological and clinical point of view 46  95  CI 34–59  Initial treatment was switched to amoxicillin n = 21 coamoxiclav n = 2 or cotrimoxazole n = 8 Thirteen conditions justifying not deescalating antibacterial therapy were detected in 11 of 48 patients who were not deescalated 23  95  CI 12–37  shock n = 5 renal abscess n = 1 obstructive uropathy n = 4 bacterial resistance or clinical contraindication to both cotrimoxazole and βlactams n = 3


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